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Fibromyalgia Overview

Difficult to diagnose, fibromyalgia is a painful disorder that is both physically and emotionally debilitating. Made even worse by a lack of a cure and no definitive cause, fibromyalgia leaves sufferers confused and frustrated about what is happening to their bodies. It is estimated that fibromyalgia afflicts as many as 5 million Americans.

Healthcare experts have found that as many as 90 percent of those afflicted with fibromyalgia are women, but it is unclear why this is the case. The disorder is most commonly found in adults and middle age is the period in which it is most frequently diagnosed. However, fibromyalgia has been known to affect both men and women of nearly any age, from children to the elderly.

What are the symptoms?

Fibromyalgia is characterized by ongoing pain, which occurs throughout the body. Sufferers often describe the pain as being similar to the body aches associated with the flu. The source of the pain is thought to come from an amplification of pain signals processed by the brain. The increased pain sensations occur in the fibers of body tissue, making the body tender to touch or pressure. Fibromyalgia has been associated with arthritis as a rheumatic condition. Like arthritis, it affects the soft tissue and causes chronic pain, but it does not affect the joints. And unlike arthritis, the symptoms of fibromyalgia can dissipate over time.

In addition to pain, the other main symptom associated with fibromyalgia is fatigue, which often makes day-to-day activities a significant struggle. Suffers often complain of being exhausted and having a “brain fog” that makes it difficult to think clearly. Although they often feel tired, people afflicted with fibromyalgia often have difficulty sleeping, due to the pain and “brain bursts” that interrupt sleep, which only compounds the feelings of exhaustion.

It is thought that certain factors may exacerbate the symptoms of fibromyalgia, but these factors may vary from one person to the next. Often, sufferers point to changes in the weather, hormonal changes, anxiety, stress and over-exertion as key factors that make their symptoms worse.

While the main symptoms of fibromyalgia are fairly well defined, the problem healthcare professionals have is that no one has been able to determine definitively what causes the disorder. There are a number of theories as to the cause, including genetic mutations, physical or emotional trauma, or an illness that triggers the disorder. Although these factors are present in many people who have fibromyalgia, they are not present in others who have the disorder. One of the most promising areas of research for a cause is genetic mutation. Researchers have discovered some genes that are more frequently found in those who have fibromyalgia.

The Road to Diagnosis

While the symptoms of fibromyalgia are frustrating for those who suffer from the disorder, obtaining a definitive diagnosis can be even more aggravating. It is not uncommon for patients to be shuffled between numerous doctors, before they receive a diagnosis of fibromyalgia. Researchers have found that, on average, it takes a person with fibromyalgia five years before they receive the correct diagnosis.

One of the biggest problems associated with diagnosing the disorder is that there are no blood or lab tests that can identify fibromyalgia. Symptoms can be vague and doctors inexperienced in diagnosing the disorder may at first be unable to identify it as fibromyalgia. Doctors also have to rule out all other disorders that may have similar symptoms, before they can definitively make a diagnosis of fibromyalgia.

Frequently, doctors will test blood counts, the erythrocyte sedimentation rate and thyroid function to rule out other diseases or disorders. Some doctors may dismiss the patient’s pain as not real, because they cannot find a cause. Doctors who do suspect fibromyalgia, may perform a pressure points test, which identifies tender points across the body. The doctor tests 18 points on the body to determine if the patient has pain in those areas. The points include the neck, shoulder, knees, elbow, chest and hips.

New guidelines though, make it easier to determine if a patient has the disorder. Patients answer a 42-question survey to help determine if they have the disorder. In order to receive a diagnosis of fibromyalgia, a patient must have had widespread pain for longer than three months. Doctors also factor symptoms such as fatigue and memory problems in their diagnosis.

Hope for the future?

Although a diagnosis of fibromyalgia is not a good thing, there is good news for those suffering from the disorder. During the last decade, many advances have been made in the diagnosis and treatment of fibromyalgia, and more research improves the odds of better treatments appearing on the near horizon.

For those who suffer from fibromyalgia, just being diagnosed and knowing what to call the disorder can be a significant relief and a major step on the road to feeling better. With treatment, most patients experience considerable improvement with their symptoms and in a high percentage of cases, the symptoms dissipate over time. However, it is not unusual for patients to go through long periods of stability; then experience relapses where periods of pain return, although less intense than before treatment.

It is also important to note that fibromyalgia is not a fatal disorder, nor does it lead to complications that can be fatal.

Finding the Right Treatment

Once a diagnosis has been made, doctors can begin to formulate a course of treatment for a patient suffering from fibromyalgia. In most cases, there is not one single treatment that works, but rather a variety of approaches that can include medications, lifestyle changes and therapy. No single approach works for everyone and it often requires some experimentation to determine the best treatment.

Medications are the primary form of treatment for fibromyalgia, but there is not one specific medication that works well for everyone. Among the types of medications that have proven effective are antidepressants. Cymbalta, also known as duloxetine, and Savella, also known as milnacipran, have proven effective in reducing the pain and fatigue that fibromyalgia patients experience. In some cases, doctors may recommend Prozac, which helps patients with sleeplessness.

Among the other types of drugs being prescribed for fibromyalgia are anti-seizure medications. Lyrica became the first drug approved by the Food and Drug Administration for the treatment of fibromyalgia. Gabapentin has also proven effective in treating the disorder. Both drugs have shown the ability to reduce the pain associated with fibromyalgia.

In some cases, over-the-counter pain relief drugs, such as, acetaminophen, ibuprofen and naproxen sodium can reduce the pain symptoms. If those are ineffective, doctors may prescribe tramadol, a non-narcotic pain-relief drug.

Along with medication, another important form of treatment is a change in lifestyle. Reducing stress is near the top of the list. Activities, such as, meditation, Tai chi and deep relaxation can improve the symptoms related to fibromyalgia and improve sleep patterns. Another important lifestyle change is to increase physical activity. Exercise is often painful for those who suffer from fibromyalgia, but an exercise program that begins slow and then gradually increases in intensity and duration is an effective way to reduce symptoms. Common exercises include, walking, biking, stretching, aerobics and swimming. Also important is to eat healthy. Altering nutrition to include healthy foods, while limiting caffeine, improves how patients feel.

Depending on the circumstances, doctors may also recommend cognitive-behavioral therapy. Such therapy can be effective in helping patients cope with chronic pain or to treat depression, a common side effect in patients with fibromyalgia.

In some cases, those suffering from fibromyalgia have experience success with alternative therapies. These include acupuncture, massage, yoga, chiropractic care and dietary supplements.

Whatever the course of treatment a patient and doctor decide on, the most important factor in success it to adhere to the treatment plan. It is not uncommon for patients, who are feeling better, to waver from a portion of their treatment, such as exercise. This often results in a re-occurrence of symptoms and a significant step backward in treatment.

Fibromyalgia patients should also work to build a network of support from friends, family members and healthcare professionals. Provide friends and family with information on fibromyalgia, so they can educate themselves on what you are dealing with. Communication can be an effective way to deal with the ups and downs of fibromyalgia treatment. Two key sources of support are the National Fibromyalgia Association and the American Chronic Pain Association, through which you can network with others suffering from the disorder. They also provide extensive information on the latest treatments and research advancements.

Another important line of communication should be with your doctor. If a course of treatment is working, but then becomes less effective over time, it is critical to discuss this change with a doctor, so a new course of treatment can be initiated.

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